Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Sep 7, 2012; 18(33): 4597-4603
Published online Sep 7, 2012. doi: 10.3748/wjg.v18.i33.4597
Gastric mucin expression in Helicobacter pylori-related, nonsteroidal anti-inflammatory drug-related and idiopathic ulcers
Doron Boltin, Marisa Halpern, Zohar Levi, Alex Vilkin, Sara Morgenstern, Samuel B Ho, Yaron Niv
Doron Boltin, Zohar Levi, Alex Vilkin, Yaron Niv, Department of Gastroenterology, Rabin Medical Center, Tel Aviv University, Petah Tikva 49100, Israel
Marisa Halpern, Department of Pathology, Rabin Medical Center, Hasharon Hospital, Petah Tikva 49100, Israel
Sara Morgenstern, Department of Pathology, Rabin Medical Center, Beilinson Hospital, Petah Tikva 49100, Israel
Samuel B Ho, Department of Medicine, University of California, and VA San Diego Healthcare System, San Diego, CA 92161, United States
Author contributions: Boltin D acquired, analysed and interpreted the data and drafted the manuscript; Halpern M and Morgenstern S interpreted the histology; Levi Z performed the statistical analysis; Vilkin A and Ho SB critically reviewed the manuscript and provided important intellectual content; Niv Y supervised the study, assisted in the drafting of the manuscript, obtained funding and provided administrative, technical support.
Supported by Beilinson Hospital Gastroenterology Department Trust Fund
Correspondence to: Yaron Niv, Professor, Department of Gastroenterology, Rabin Medical Center, Tel Aviv University, 39 Jabotinski Street, Petah Tikva 49100, Israel. nivyaron80@gmail.com
Telephone: +972-3-9377237 Fax: +972-3-9210313
Received: January 21, 2012
Revised: February 27, 2012
Accepted: March 20, 2012
Published online: September 7, 2012
Abstract

AIM: To determine the pattern of secreted mucin expression in Helicobacter pylori (H. pylori)-related, nonsteroidal anti-inflammatory drug (NSAID)-related and idiopathic gastric ulcers.

METHODS: We randomly selected 92 patients with H. pylori-associated (n = 30), NSAID-associated (n = 18), combined H. pylori and NSAID-associated gastric ulcers (n = 24), and patients with idiopathic gastric ulcers (n = 20). Immunohistochemistry for T-cell CD4/CD8, and for mucin 5AC (MUC5AC) and mucin 6 (MUC6), was performed on sections of the mucosa from the ulcer margin. Inflammation score was assessed according to the Sydney system.

RESULTS: MUC5AC was expressed on the surface epithelium (98.9%) and neck glands (98.9%) with minimal expression in the deep glands (6.5%). MUC6 was strongly expressed in the deep glands (97.8%), variable in the neck glands (19.6%) and absent in the surface epithelium (0%). The pattern of mucin expression in idiopathic ulcer margins was not different from the expression in ulcers associated with H. pylori, NSAIDs, or combined H. pylori and NSAIDs. CD4/CD8 ratio was higher in H. pylori-positive patients (P = 0.009). Idiopathic ulcers are associated with hospitalized patients and have higher bleeding and mortality rates.

CONCLUSION: Idiopathic ulcers have a unique clinical profile. Gastric mucin expression in idiopathic gastric ulcers is unchanged compared with H. pylori and/or NSAID-associated ulcers.

Keywords: Idiopathic ulcer, Mucin, Mucin 5AC, Mucin 6, Helicobacter pylori